The Puerto Rico NCI Community Oncology Research Program (PRNCORP) will be the principal organization in the island that promotes cancer prevention, control and screening/post-treatment surveillance clinical trials. It will conduct cancer care delivery research and will provide access to treatment and imaging clinical trials conducted under the reorganization of the National Clinical Trials Network (NCTN). It will evaluate disparity issues and outcomes in cancer care delivery and treatments. The program will accelerate the transfer of new knowledge to treat, control and prevent cancer in the community. The PRNCORP will build and expand upon the scope and activities of the previously NCI-funded San Juan MBCCOP with a more comprehensive approach to adult and pediatric oncology. The island of Puerto Rico, USA, is 100 miles by 35 miles. It is located in the Caribbean Sea, 1,200 miles from the US mainland. The last census of 2010 revealed a population of 3.7 million. The island cancer registry reports about 12,500 new cancer cases per year. There is an excess incidence of cancer as compared with mainland USA for tobacco/alcohol related malignancy especially head and neck, esophageal and liver cancer. Also there is an increased mortality in cervical, uterine and gastric cancer. 40% of the population is medically uninsured but depends on a Medicaid type program called Mi Salud that reaches all areas of the island. The PRNCORP will interact and participate with NCORP-research bases including but not limited to: 1) ECOG-ACRIN, 2) NRG, 3) MD Anderson, 4) University South Florida, 5) Wake Forest University, 6) CTSU, and 7) COG. The program has expanded to include 4 hospitals, one University Cancer Center, 3 radiology groups, 2 radiation oncology facilities, 9 medical oncology groups and 1 primary care physician group. The program will have 85 investigators including 11 oncology fellows in-training. The PRNCORP will continue to expand its activities and increase the participation of more cancer healthcare professionals and institutions in the island. It will develop research affiliations with NCI-sponsored research bases that offer meaningful and other culturally sensitive cancer care delivery research.